Experience in 118 consecutive patients undergoing CT-guided stereotactic surgery utilizing the cosman–robert–wells (CRW) frame

G. R. Sherma, Jinnah Postgraduate Medical Centre, Karachi
H. Siddiqui, Jinnah Postgraduate Medical Centre, Karachi
Rashid Jooma, Aga Khan University


Aims: To evaluate the efficacy of CT-guided neurosurgical procedures done on patients operated by this modality. Methods: Between January 1997 and March 2000, 118 patients undergoing CT-guided stereotactic procedures were recruited to the study. The CRW III stereotactic system (Radionics, USA) and the TSX-00ZA CT Scanner (Toshiba, Japan) were used for all the procedures in the series. These procedures were directed to symptomatic brain lesions or for the treatment of Parkinsonian tremor. Results: Of 118 patients, 109 had intra-cranial lesions and 9 had Parkinson's Disease. The stereotactic procedures performed on these patients were: biopsies in 62, guided mini-craniotomies in 22, haematoma evacuation in 11 cases, aspiration of abscess in 8 cases, 2 biopsy/aspiration of cysts, 4 placement of catheters and 9 thalamotomies. A histological diagnosis was made in 98.15% while no diagnosis was reached in 1.85%. Morbidity and mortality were 5.92% and 2.55% respectively. Conclusion: CT-guided stereotactic surgery using the CRW frame is accurate, quick, safe and highly effective